Manning Kathryn Y, Fehlings Darcy, Mesterman Ronit, Gorter Jan Willem, Switzer Lauren, Campbell Craig, Menon Ravi S
Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.
Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
J Child Neurol. 2015 Oct;30(11):1507-14. doi: 10.1177/0883073815572686. Epub 2015 Mar 11.
The aim was to identify neuroimaging predictors of clinical improvements following constraint-induced movement therapy. Resting state functional magnetic resonance and diffusion tensor imaging data was acquired in 7 children with hemiplegic cerebral palsy. Clinical and magnetic resonance imaging (MRI) data were acquired at baseline and 1 month later following a 3-week constraint therapy regimen. A more negative baseline laterality index characterizing an atypical unilateral sensorimotor resting state network significantly correlated with an improvement in the Canadian Occupational Performance Measure score (r = -0.81, P = .03). A more unilateral network with decreased activity in the affected hemisphere was associated with greater improvements in clinical scores. Higher mean diffusivity in the posterior limb of the internal capsule of the affect tract correlated significantly with improvements in the Jebsen-Taylor score (r = -0.83, P = .02). Children with more compromised networks and tracts improved the most following constraint therapy.
目的是确定强制性运动疗法后临床改善的神经影像学预测指标。对7名偏瘫型脑瘫患儿进行了静息态功能磁共振成像和扩散张量成像数据采集。在基线时以及为期3周的强制性治疗方案后的1个月后获取了临床和磁共振成像（MRI）数据。表征非典型单侧感觉运动静息态网络的基线偏侧指数越负，与加拿大职业表现测量得分的改善显著相关（r = -0.81，P = 0.03）。患侧半球活动减少的更单侧化网络与临床评分的更大改善相关。患侧传导束内囊后肢的平均扩散率较高与Jebsen-Taylor评分的改善显著相关（r = -0.83，P = 0.02）。网络和传导束受损更严重的儿童在强制性治疗后改善最为明显。
